BACKGROUND Dual checkpoint inhibition improves response rates in treatment naive patients with metastatic melanoma compared to monotherapy.However,it confers a higher rate of toxicity,including immune-related colitis....BACKGROUND Dual checkpoint inhibition improves response rates in treatment naive patients with metastatic melanoma compared to monotherapy.However,it confers a higher rate of toxicity,including immune-related colitis.Steroids may not resolve symptoms in all cases.The use of vedolizumab,a humanized monoclonal antibody againstα4β7 integrin has proven effective in cases refractory to standard treatment.CASE SUMMARY We report the case of a 27-year-old female with Stage IVd metastatic melanoma treated with ipilimumab and nivolumab.She developed severe colitis refractory to methylprednisolone,infliximab and mycophenolate mofetil but responded to vedolizumab.CONCLUSION This case report supports vedolizumab use in severe immune related colitis refractory to standard immunosuppression.展开更多
Xanthomas are rare bone tumors that occur more often in the appendicular skeleton and typically appear radiographically benign,with a narrow zone of transition and a sclerotic rim.We report the case of a 57-year-old w...Xanthomas are rare bone tumors that occur more often in the appendicular skeleton and typically appear radiographically benign,with a narrow zone of transition and a sclerotic rim.We report the case of a 57-year-old woman with hyperlipidemia presenting with bilateral shoulder pain after minor trauma.Radiographic and histopathologic investigation demonstrated intraosseous xanthoma with atypical features,including multifocality,a wide zone of transition and pathologic fractures-characteristics more commonly associated with aggressive lesions such as multiple myeloma or metastasis.The diagnosis,imaging,and histological appearance of xanthoma of bone are reviewed.展开更多
文摘BACKGROUND Dual checkpoint inhibition improves response rates in treatment naive patients with metastatic melanoma compared to monotherapy.However,it confers a higher rate of toxicity,including immune-related colitis.Steroids may not resolve symptoms in all cases.The use of vedolizumab,a humanized monoclonal antibody againstα4β7 integrin has proven effective in cases refractory to standard treatment.CASE SUMMARY We report the case of a 27-year-old female with Stage IVd metastatic melanoma treated with ipilimumab and nivolumab.She developed severe colitis refractory to methylprednisolone,infliximab and mycophenolate mofetil but responded to vedolizumab.CONCLUSION This case report supports vedolizumab use in severe immune related colitis refractory to standard immunosuppression.
文摘Xanthomas are rare bone tumors that occur more often in the appendicular skeleton and typically appear radiographically benign,with a narrow zone of transition and a sclerotic rim.We report the case of a 57-year-old woman with hyperlipidemia presenting with bilateral shoulder pain after minor trauma.Radiographic and histopathologic investigation demonstrated intraosseous xanthoma with atypical features,including multifocality,a wide zone of transition and pathologic fractures-characteristics more commonly associated with aggressive lesions such as multiple myeloma or metastasis.The diagnosis,imaging,and histological appearance of xanthoma of bone are reviewed.
